Provider Demographics
NPI:1962797324
Name:TORRES, ISARYS (MT)
Entity type:Individual
Prefix:MS
First Name:ISARYS
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3605
Mailing Address - Country:US
Mailing Address - Phone:786-728-0389
Mailing Address - Fax:
Practice Address - Street 1:2648 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2031
Practice Address - Country:US
Practice Address - Phone:305-485-0944
Practice Address - Fax:305-485-0966
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 63556225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist